河北省精神分裂症患者应用抗精神病药物治疗现状

Present Survey on Antipsychotic Medications to the Patients with Schizophrenia in Hebei Province

目的调查河北省精神分裂症患者抗精神病药的使用现状及三级(省级、市级、县级)医院的处方差异。方法使用自制调查问卷,按一定的抽样比例,选择河北省37家专科医院或综合医院精神科进行调查,共调查603例精神分裂症患者。结果 1接受单一药物治疗421例(69.8%),联合治疗182例(30.2%);2使用频率前7位的药物分别是:氯氮平、利培酮、氯丙嗪、奋乃静、奎硫平、氟哌啶醇和奥氮平;3氯氮平、氯丙嗪的使用频率市级、县级医院高于省级医院(P<0.05,P<0.01),奎硫平的使用频率省级医院高于市级、县级医院(P<0.01);氯氮平的使用剂量县级医院高于省级、市级医院(P<0.01);4合并使用安坦者30.4%,合并苯二氮卓类药物者22.2%,合并使用β-受体阻滞剂者17.1%,合并心境稳定剂者11.8%,合并抗抑郁剂者5.8%;合并心境稳定剂及安坦者市级、县级医院高于省级医院(P<0.05,P<0.01)。结论河北省精神分裂症精神药物的使用方式合理,多数患者接受单一药物治疗,药物剂量在临床推荐的治疗剂量范围内。第二代抗精神病药的使用逐渐增多。氯氮平的广泛应用仍是我省精神药物使用的一个特点。3个级别的医院在药物选择上有些差异,受医生的用药习惯影响。

Objective To investigate the use patterns of antipsychotic medications to the patients with schizophrenia in Hebei Province,and analyze the difference among three different classes hospitals.Methods A total of 603 patients with schizophrenia were surveyed using the retested and revised self-made questionnaire,with the same sampling ratio,37 hospitals in Hebei Province during 19～23th,Nov,2007.Results ①A total of 421（69.8%）cases were treated with mono-pharmacy,182（30.2%）cases were treated with poly-pharmacy.②Antipsychotic medication most frequently prescribed was Clozapine,subsequently were Risperidone,Chlorpromazine,Perphenazine,Quetiapine,Haloperidone and Olanzapine.③The frequently prescribed clozapine and chlorpromazine in municipal hospitals,county hospitals were higher than provincial hospitals（P0.05,P0.01）.The frequently prescribed quetiapine in provincial hospitals was higher in municipal hospitals and county hospitals（P0.01）.The doses prescribed clozapine in county hospitals were higher than provincial hospitals and municipal hospitals （P0.01）.④The common concomitant medications were anticholinergic agents（30.4%）,benzodiazepine （22.2%）,β-recepter blockades（17.1%）,mood stabilizers（11.8%）,antidepressants（5.8%）.The combined with mood stabilizers and anticholinergic agents in municipal hospitals,county hospitals were higher than in Provincial hospitals（P0.05,P0.01）.Conclusion The treatment of schizoprenia in Hebei Province is basic norm.Most patients were treated with mono-pharmacy.The doses prescribed were in the recommended clinical context.Atypical antipsychotics are gradually the major to treat schizophrenia in Hebei Province.Extensive use of clozapine is still extensively used in Hebei Province.